Funds 16 Projects to Reduce Pressure Ulcers in Nursing Home Residents

ALBANY, N.Y. (Dec. 26, 2007) – The New York State Department of Health has awarded $800,000 to 16 nursing homes to support implementation of an evidence-based best practice shown to significantly reduce pressure ulcers.

Known as "On-Time Quality Improvement for Long Term Care," the approach to preventing pressure ulcers was developed by the federal Agency for Healthcare Research and Quality (AHRQ).

A pressure ulcer (also called a bedsore) is an area of skin that breaks down when a person stays in one position for too long, putting pressure on the same spot without shifting weight. They occur most often in people who are bedridden or in wheelchairs, even for a short time after surgery or an injury.

"The State Health Department is pleased to work with AHRQ and nursing homes across New York on this important effort to improve the health and well-being of nursing home residents in the state," said State Health Commissioner Richard F. Daines, M.D. "In addition to creating pain and suffering, pressure ulcers can become infected, causing fever, confusion, weakness and even death. They are also very preventable, and costly to treat."

Nursing home residents at highest risk for pressure ulcers are those in a coma and others who can't move around or change position on their own. Among this high-risk population the incidence of pressure ulcers is 14 percent in the state (the U.S. average is 12 percent). Among low-risk patients in New York, the incidence is 2 percent (the same as the national average).

The "On-Time" program uses health information technology (HIT) to collect, analyze and promptly report back to staff the information they need to identify which nursing home residents are at risk for pressure ulcers and to track the results of their efforts to reduce risk. It has been implemented, tested and refined in more than 35 nursing homes across the nation and produced an average decrease of 33 percent in prevalence rates in the nursing homes that implemented the model.

The On Time approach recognizes that Certified Nursing Assistants (CNAs) are a critical member of the care team and are a crucial staff source of information about residents. The model also recognizes that staff needs timely feedback reports on residents and regular communication with each other on residents at risk in order to get the right intervention in place to prevent the development of a pressure ulcer.

"The Department is committed to sustained efforts that will bring down prevalence rates of pressure ulcers in New York's nursing homes," said Mark L. Kissinger, Deputy Commissioner for the Office of Long-Term Care. "These grants make it possible for nursing homes to purchase the health information technology needed to implement this preventive program – providing a new way of collecting and analyzing data and turning it into timely information that is put to immediate use."

"We are excited to work with the New York State Department of Health to improve the quality of care in nursing homes," said AHRQ Director Carolyn M. Clancy, M.D. " The On-Time program gives nursing homes the tools they need to prevent pressure ulcers and make CNAs an integral part of the quality improvement team. This is a major advance toward putting evidence-based research into practice."

The grants are financed with civil monetary penalty funds, each award to be made at the capped level of $49,999. Awards will be made to the following nursing homes: